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Erschienen in:
17.01.2020 | Editorial
Are Suprapapillary Biliary Stents Superior to Transpapillary Biliary Stents?
Erschienen in: Digestive Diseases and Sciences | Ausgabe 4/2020
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Although the duration of patency of biliary stents has been significantly prolonged by the introduction of self-expanding metal stents (SEMS), stent occlusion still remains a major concern. Generally, transpapillary stent placement, where the distal end of the stent traverses the sphincter of Oddi, is favored. The mechanism of stent occlusion is likely related to several factors, including stent-related factors (e.g., diameter, shape, material, side holes) and external factors (bacterial adherence and deposition of dietary fibers into the stent lumen) [1]; the latter may be partially addressed by utilizing stents with anti-reflux mechanisms. In a recent randomized trial, such stents prolonged patency and reduced the incidence of ascending cholangitis [2]. Maintaining the function of the sphincter of Oddi by placing the stent above the sphincter (i.e., suprapapillary or intraductally) might be another approach to solving this problem (Fig. 1).
Fig. 1
Suprapapillary and transpapillary stent placement
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